Comparative characteristic of the effect of anti-inflammatory therapy on the blood and urine levels of growth factors in patients with rheumatoid arthritis

Abstract

The purpose of our work was to compare the effect of aceclofenac and meloxicam on the level of transforming growth factor-β1 (TGFβ1) and vascular endothelial growth factor in the blood and urine in chronic kidney disease (CKD) patients with rheumatoid arthritis (RA). Methods. RA patients were allocated into three groups: I group included the patients with RA without CKD presence (n = 47), group II – patients with RA with CKD stage 1 (n = 46), group III – patients suffered from RA with CKD stage 2 (n = 45). To form the group of comparison 20 healthy persons of appropriate age category were examined. Complex clinical-laboratory examination of all patients was performed during the period of extensive clinical manifestations (before nonsteroid anti-inflammatory drug (NAIP) administration), in a week and in 2 weeks during carrying out therapy with NAIP. Treatment was also carried out in accordance with the existing principles of therapy RA and of the revealed nephrologic diseases. In a complex of patients’ therapy aceclofenac was included. Influence of aceclofenac was compared with meloxicam. Concentrations of TGFβ1 and vascular endothelial growth factor (VEGF) in the blood and urine were studied using an immunofermental method. Results. In a week of anti-inflammatory therapy, a significantly decrease in the levels of the studied factors was found in all patients’ groups. The blood VEGF level was lower by 11.90% in the aceclofenac group compared to the meloxicam group. Urine VEGF and TGFβ1 levels were decreased by 5.53% and 39.40%, respectively, in patients with aceclofenac therapy compared with the meloxicam group. After two weeks of the aceclofenac therapy a significant decrease of TGFβ1 and VEGF in the blood (p<0.05) and urine (p <0.001) of the CKD patients with RA were determined. Conclusion. The use of aceclofenac as a new generation of NSAIDs for the complex treatment of patients with RА and comorbid CKD improves the therapy efficiency due to reducing the blood and urine levels of growth factors.

Keywords

• chronic kidney disease, transforming growth factor-β1, vascular endothelial growth factor, rheumatoid arthritis